At the core of the workers’ compensation system in America is the compromise between the employer and the injured employee: That the employer won’t face civil litigation, for which it would potentially be liable for big payouts for pain and suffering and other damages, while the worker doesn’t have to be fault-free and the process to get benefits is supposed to be faster.

Based on these principles, there are a number of presumptions that are made that are supposed to tilt the scales slightly in favor of the worker. Among those is that workers’ compensation acts are supposed to be liberally construed to accomplish the purpose of providing injured workers benefits. So doubts are supposed to be resolved in favor of the worker.

This does not mean the worker will necessarily have benefits handed to them or that he or she won’t have to fight for them.

Plaintiff was an ironworker who had been on the job since early 2004. Often, this position involved heavy manual labor, including carrying heavy equipment, hauling 50-pound buckets with ropes, using jackhammers and pulleys, climbing scaffolding and welding. Plaintiff did this work without restrictions or issues for four months.

Then one day, while installing concrete wall panels on a building, the panel slipped. Plaintiff jerked forward to hold on to the panel and then had to move back before letting go so the panel wouldn’t hit his toes. He later said there was an immediate sharp pain in his right lower back. At the time, there was no pain in his shoulders.

Worker was taken for treatment at a local medical center, where he was diagnosed with lower back strain. He was taken off duty for the rest of the day, but told by the doctor he could go back the following day with restricted duties.

The company’s initial injury report didn’t contest that the injury occurred at work or that it was covered by workers’ compensation. Although he was told by doctors he could return to work with modified duties, worker did not go back because he felt he couldn’t handle even light duties.

He then visited a new doctor at a different health system. He complained of pain on his right side on his upper back, buttock and knee. He was diagnosed with lumbar sprain and right leg sciatica and taken off duty.

He continued receiving treatment over the following weeks for numerous pains, including pain in both shoulders, legs, hips, feet and back.

Two months after the accident, he visited an orthopedic surgeon and told him he had broken both of his shoulders years earlier, but never had surgery and did not suffer any pain until a few days after the work accident.

However, the company denied his claim for benefits on the shoulder injury, saying it wasn’t work-related and instead was the cause of a prior injury.

The Disability Compensation Division hearing director determined the shoulder injuries were a result of the accident, and that the company hadn’t provided sufficient evidence to support a denial. The company was ordered to pay for medical care, services and supplies for the injuries – including of the shoulder.

Employer appealed to the industrial relations appeals board, which found substantial evidence rebutted the presumption that his injuries were related to his job and limited his temporary disability payments to his back injuries. The appeals court affirmed, but the state supreme court vacated that judgment. Defendants had not provided substantial evidence to rebut the assertion that plaintiff’s injuries were work-related and the court shouldn’t have relied solely on the physician’s report in limiting benefits.